Individual
ANN KHAZZANDRA MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4432 LAS POSITAS RD, LIVERMORE, CA 94551-9529
(925) 724-2422
Mailing address
2656 MELBOURNE WAY, SAN RAMON, CA 94582-5768
(510) 673-6707
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
50388
CA
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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